Medical instrument control system

ABSTRACT

A medical-instrument service providing system receives an online order for a medical instrument via a communication network from a service utilizing terminal of a medical institution, accesses a stock control server controlled by a supplier of the medical instrument, to check whether or not the on-order medical instrument is in stock in the supplier. If the on-order medical instrument is in stock in the supplier, the system instructs to deliver the medical instrument to the medical institution. If the on-order medical instrument is insufficient in stock, the system accesses a stock control server, controlled by other institution than the medical instrument, to check whether or not the instrument is in stock, via the communication network. If the on-order medical instrument is in stock, the system instructs to supply the medical instrument to the medical institution from the other institution.

FIELD OF THE INVENTION

[0001] The present invention relates to a system including medicalinstitutions such as a hospital and a medical laboratory and a supplierto supply a medical instrument to these medical institutions.

[0002] More particularly, the present invention relates to a method ofsupplying a medical instrument to medical institutions such as hospitalsand medical laboratories and a system to check a stock status of themedical instrument.

[0003] Further, the present invention relates to a service providingmethod and service providing system to support selection of medicalinstrument for medical institutions such as hospitals and medicallaboratories.

[0004] Further, the present invention relates to an electronic medicalrecording system and a medical foolproof system utilized in medicalinstitutions such as hospitals and medical laboratories.

[0005] Further, the present invention relates to a medical instrumentcontrol method and control system for controlling a medical instrumentused in the medical institutions such as hospitals and medicallaboratories.

BACKGROUND OF THE INVENTION

[0006] In medical institutions such as hospitals and medicallaboratories, various medical instruments are used in surgery andmedical inspections. The medical instruments are e.g. tools, medicine,and implanted devices including implanted tools (devices surgicallyplaced in the body such as an intraocular lens, a pacemaker andartificial organs). Further, the medical institutions use these variousinstruments supplied from suppliers such as makers. Some of theinstruments are stocked in the medical institutions, and otherwise,orders for some instruments are placed with the suppliers when required.

[0007] However, in the medical institutions, it is very troublesome tocontrol stocks of the medical instruments because timing of use cannotbe predicted without difficulty, and various types of instruments areused. Generally, patients fall ill unexpectedly and demands cannot bepredicted without difficulty, and calculated control cannot beperformed. On the other hand, in the scene of medical service, emergentsurgery and inspections may be frequently performed. Accordingly, it isa very serious object to construct a system to quickly supply medicalinstruments. This is a specific problem to the field of medicaltreatment.

[0008] Especially, a part of implanted tools and medicine are degradedwith time, and they are not appropriate for long-term storage. As themedical institutions cannot hold such instruments for a long period,they repeat ordering in accordance with necessity. That is, a highfrequency of ordering must be made. Further, the makers must predictdemands and control manufacturing and quick supply of products so as tocover every possible situations.

[0009] As an example of implanted tool which is degraded with time, anintraocular lens (including an intraocular contact lens) used inophthalmologic surgery is known. A hospital selects a lens appropriateto a patient's eye and uses it in the surgery. However, intraocularlenses have various sizes and shapes corresponding to individuality ofpatients, and a lens necessary for surgery is not always stocked in thehospital. Further, if the patient's eye has an extraordinary size and/orshape, an appropriate intraocular lens may be out of stock even in thelens maker. However, in emergency ophthalmologic surgery, the supply oflens must not be delayed.

[0010] Further, the medical institutions have another problem. That is,the selection of implanted tool appropriate to a patient greatly dependson a responsible doctor's expert knowledge and experience, i.e.,so-called know-how. In the case of intraocular lens, a doctor of thehospital performs ophthalmologic measurement and diagnosis on thepatient, and selects an intraocular lens having optimum size and shapefor the patient based on the results of measurement. Severalmathematically-expressed selection criteria for calculation of lenspower are known. However, in some cases, the coefficient used in thecalculation may be changed in accordance with the type of intraocularlens (difference in makers etc.). The coefficient, corresponding to theabove know-how of each doctor, may cause a difference in type offinally-selected intraocular lens in accordance with a numerical valuedetermined by the doctor. That is, how to improve the selection criteriato a higher level and attain homogeneity is a significant problem.

[0011] Further, in the medical institutions, by virtue of thedevelopment of recent information technology, electronization ofpatients' medical records is expected. In conventional patients' medicalrecords, personal data, medical measured values and the like arewritten, however, in electronic medical records, more input items can berealized and detailed information on medical products used forrespective patients can be recorded. As to surgically used tools such asimplanted tools, to prevent omission of input or input error to theelectronic medical record, it is desirable to input product informationto the record on the spot of surgery. Accordingly, one of the problemsis how to realize the on-the-spot input for prevention of omission ofinput or input error.

[0012] In the case of intraocular lens as an example of implanted tool,as described above, one intraocular lens appropriate to a patient's eyeis selected from various types of intraocular lenses. There may be noproblem if a doctor who selects a lens and a doctor who surgically placethe selected lens in the patient's eye are the same person; otherwise,the record of lens made by the doctor who selected the lens is the onlyinformation of intraocular lens to be surgically placed in the patient'seye. Accordingly, to perform the safest surgery, a foolproof system isdesired to finally check an intraocular lens to be used in surgerybefore the surgery, and how to realize the system is a further problem.

SUMMARY OF THE INVENTION

[0013] The present invention has been made in consideration of the aboveproblems specific to the medical field, and has its object to solve theproblems related to supply of medical instruments, i.e., demands cannotbe predicted without difficulty, and further, the instruments must bequickly supplied, by constructing novel method and system.

[0014] A more particular object of the present invention is to providemethod and system for online ordering for a medical instrument byutilizing a communication network in a timely and economical manner.

[0015] Another object of the present invention is to provide method andsystem for online ordering for a medical instrument appropriate to apatient in a simple manner by utilizing a communication network.

[0016] Further, another object of the present invention is to providemethod and system for efficient delivery and manufacturing control for amaker of medical instrument by utilizing a communication network.

[0017] Further, another object of the present invention is to providemethod and system for providing an excellent after-sales serviceregarding a medical instrument by utilizing a communication network.

[0018] Further, another object of the present invention is to providemethod and system for reduction of shortage of medical instruments byutilizing a communication network.

[0019] Further, another object of the present invention is to providemethod and system of service for supporting medical institutions toselect a medical instrument appropriate for a patient by utilizing acommunication network.

[0020] Further, another object of the present invention is to providemethod and system for providing a service to support selection ofmedical instrument, with a selection criterion which is advanced inaccordance with increment in number of use of service.

[0021] Further, another object of the present invention is to providemethod and system to foster timely development and improvement ofmedical products and after-sales support service by utilizing acommunication network.

[0022] Further, another object of the present invention is to solve theabove problems related to use of medical instruments in medicalinstitutions by constructing a novel system.

[0023] More particularly, one of the objects of the present invention isto provide an electronic medical recording system for medical servicesto cover every possible situations for each patient.

[0024] Further, another object of the present invention is to provide afoolproof system upon use of medical instrument to a patient and aterminal apparatus to realize the system.

[0025] Other features and advantages of the present invention will beapparent from the following description taken in conjunction with theaccompanying drawings, in which like reference characters designate thesame name or similar parts throughout the figures thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

[0026] The accompanying drawings, which are incorporated in andconstitute a part of the specification, illustrate embodiments of theinvention and, together with the description, serve to explain theprinciples of the invention.

[0027]FIG. 1 is a block diagram showing a hardware network constructionof service system;

[0028]FIG. 2 is a flowchart showing a procedure in a medicalinstitution;

[0029]FIG. 3 is a flowchart showing a procedure of service by a providerof medical instrument;

[0030]FIG. 4 is an example of screen image for service selection;

[0031]FIG. 5 is an example of screen image for inputting patient data;

[0032]FIG. 6 is an example of screen image showing a list of searchresult;

[0033]FIG. 7 is an example of screen image of online new ordering;

[0034]FIG. 8 is an example of screen image for checking online ordering;

[0035]FIG. 9 is an example of screen image of electronic medical record;and

[0036]FIG. 10 is an overview of product package of intraocular lens.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0037] Preferred embodiments of the present invention will now bedescribed in detail in accordance with the accompanying drawings.

[0038] In the following description, as an example of medicalinstrument, an intraocular lens (IOL) placed in a patient's eye will beused. The IOL is an example of an implanted tool placed in a patient'sbody. However, the present invention is not limited to the intraocularlens but is applicable to other implanted tools (a pacemaker, artificialorgans, dental implants, artificial bones and the like to be placed inthe body). Further, the present invention is applicable to medicalinstruments selected for respective patients such as specializedinstruments used in surgery using the above implanted tools, medicine,consumables used in examinations and treatments, and the like.

[0039]FIG. 1 is a block diagram showing the entire construction ofinformation communication network including medical institutions such asa hospital and a medical laboratory and a supplier (company organizationhaving a manufacturing department, a business department, a distributiondepartment and the like) of medical instrument used in the medicalinstitutions. In FIG. 1, a hospital A (1), a hospital B (2), a medicallaboratory (3) and a lens supplier (4) (medical instrument supplier) areinterconnected via the Internet (5).

[0040] In the hospital A (1), a hospital LAN (Local Area Network) (10)is constructed, and computer devices and medical measuring devices heldin respective clinical departments, a department A (11), a department B(12), a department C (13) and a department D (14), are interconnectedvia the LAN. If the hospital A is a general hospital, the hospital hasdepartments of various fields. For example, in the field ofophthalmology, various medical measuring devices such as a refractometerfor measurement of refraction, a keratometer (ophthalmometer) formeasurement of corneal power, an ultrasonic haploscope for measurementof axial length, a visuscope for measurement of visual acuity, a digitalretinal camera for obtaining a fundus image, a velocimeter for bloodvelocity mesurement of retinal bloodflow, a perimeter for measurement ofvisual field, tonometer for measurement of ocular pressure, and thelike, are used.

[0041] The hospital LAN (10) is connected to an electronic medicalrecording system (15) and a hospital stock control system (16). Theelectronic medical recording system (15) has a server which includes adatabase for control of all the electronized patient information handledin the respective departments and which is accessible from therespective departments in client/server form. More particularly, thepatient information includes patient identification data (ID code, nameand the like), examination and treatment records (date, contents ofexamination, examination data, doctor's findings, contents of treatment,medical instruments) and the like. The medical instruments areinstruments, medicine, tools attached/placed to/in the body includingimplanted tools, and the like. FIG. 9 is an example of user interfacefor electronic medical recording. The above-described patientinformation is displayed.

[0042] The hospital stock control system (16) has a server including adatabase for control of stocked medical instruments used in thehospital. The stock control system controls the medical instruments byproduct serial code. The hospital stock control system (16) isaccessible from the respective clinical departments and stock controldepartment of the hospital in client/server form. Further, as describedlater, the medical instrument supplier is permitted, on some conditions,to access the hospital stock control system (16) via an external network(in the present embodiment, the supplier can access only data related tostock statuses of products of the supplier). A doctor or assistant toperform treatment can check whether or not medical instrument(s)necessary for the treatment or examination are stocked in the hospitalby accessing the hospital stock control system (16) from an accessterminal (PC or workstation) of the department.

[0043] Similarly, in the hospital B (2) different from the hospital A(1), a department A (21), a department B (22), a department C (23), anelectronic medical recording system (25), a hospital stock controlsystem (26) and the like are interconnected as a network via a hospitalLAN (20). The details of the electronic medical recording system (25)and the hospital stock control system (26) are the same as those in thecase of the hospital A (1). The difference from the hospital A (1) isthat the hospital LAN (20) of the hospital B (2) is connected to afurther local service providing system 24. As described later, theservice providing system 24 includes a server to provide a selectionsupport service to select an appropriate medical instrument from patientinformation, and the server is accessible from the respectivedepartments of the hospital B in client/server form.

[0044] Further, in the medical laboratory (3) different from thehospital A (1) and the hospital B (2), a department A (31), a departmentB (32) and a department C (33) are interconnected as a network via alaboratory LAN 30. The LAN is connected to a stock control system (35)and a database system (34) holding research data, and accessible fromthe respective departments in client/server form.

[0045] The lens supplier (4) is given as an example of medicalinstrument supplier. In this embodiment, it is a supplier of intraocularlens for medical surgery as example of implanted tool. The supplier maybe any type of company as long as it is within the scope of the presentinvention. For example, the supplier may be any of other companies whichsupply other implanted tools (a pacemaker, artificial organs, dentalimplants, artificial bones and the like), medicine, consumables used inexaminations and treatment, and the like. In the lens supplier (4), abusiness distribution department (41) (including sales and distributionsections), a development department (42) and a manufacturing department(43) are interconnected as a network via a company LAN (40). The networkis connected to a company stock control system (44), an online orderingsystem (45), and a service providing system (46) for supportinglens-selection and the like. The company stock control system (44) has aserver including a database for controlling stock statuses of all theproducts handled by the lens supplier. The online ordering system (45)has a server to receive online orders for products from the medicalinstitutions (1, 2 and 3) as customers via the Internet (5).

[0046] The service providing system (46) has a server to provide aservice to support selection of lens in correspondence with a patient bythe above customer, and provides an online service in client/serverform. The particular services will be described later. The onlineordering system (45) and the service providing system (46) respectivelyhave hardware constituents including a storage device (hard disk ormemory) holding a computer program defining a procedure of the serviceand data group of the database, a processor (computation device) forexecution of the program, and a network interface for connection withthe LAN.

[0047] Note that instead of execution of program of all the servicefunctions by the processor on the server side, a program defining a partor all of the functions of the service (, and data of the database ifnecessary,) may be held on the client (service utilizing terminal) sidefor execution of the function(s) by the processor on the client side. Inthis case, the program executed on the client side may be transferredvia the network from the server to the client, or may be previouslyinstalled as software to use the service in the storage device of theclient. For the sake of quick service update, it is preferable todownload the program in form of applet from the server to the client viathe network upon every use of the service and execute the program on theclient side.

[0048] The LANs of the hospital A (1), the hospital B (2), the medicallaboratory (3) and the lens supplier (4) are connected to the Internet(5) via a gateway (not shown) including a firewall. For protection ofprivacy of patients and the hospitals, a high level security function isnecessary for use of the Internet allowing use of public line. For thispurpose, a security system using encrypted data communication and userID and password is employed. To completely exclude possibility of thirdperson's intrusion, a private communication line (6) may be used withoutthe Internet for data communication between the lens supplier (4) andthe hospital (1). Further, the respective servers (46 and 45) to providethe online ordering service and the lens-selection support servicecontrolled by the lens supplier (4) may be placed, not on the LAN (40)in the lens supplier (4) but on a rental server (7) provided on theInternet by a third person. In this case, the lens supplier (4) performsprogram correction and data transfer via the Internet (5), thus remotelycontrols the contents of the rental server (7).

[0049] The hardware network construction is as described above. Next,particular contents and procedures of the service will be described.

[0050]FIG. 2 is a flowchart showing a standard procedure in the medicalinstitution (the hospital A, the hospital B or the medical laboratory)utilizing the present service system. Since the intraocular lens hasvarious sizes and shapes corresponding to individuality of patients, adoctor or examination technician, or assistant in the respectivedepartments is to perform an operation to select an intraocular lensappropriate to a patient. The lens supplier provides the lens-selectionsupport service for selecting a lens appropriate to a patient byutilizing various information related to lenses owned by the company.

[0051] In FIG. 2, at step 101 (log on to service), a doctor orexamination technician or assistant in the respective departments of themedical institution accesses the service providing server of desiredlens supplier via the LAN and the Internet from the service utilizingterminal (PC or workstation connected to the network). At this time,user code and password provided to the service user are inputted, and abutton of desired service is depressed. Only a registered user (thehospital A or staff of the hospital) can log on to the service. As shownin FIG. 4, service selection buttons are “lens selection support” and“online ordering”.

[0052] Step 102 (input patient data) and the subsequent steps areprocedure steps performed when the lens selection support service hasbeen selected. Patient information of a patient to take surgery forplacement of intraocular lens is inputted. FIG. 5 is an input screenimage displayed on the service utilizing terminal. If the “lensselection support” button as shown in FIG. 4 is clicked by a mouse ofthe service utilizing terminal, the screen image as shown in FIG. 5 isdisplayed. Input data items are a patient ID, a keratometric value(corneal refraction) measured by a keratometer (refractometer), an opticaxis length measured by a ultrasonic haploscope, a post-surgeryrefraction of the patient's eye after insertion of the intraocular lens,a corneal diameter, a pupil diameter, naked eye sight, corrected eyesight, a spherical angle upon correction, astigmatism refraction and anastigmatism axial angle. Further, there are selection items ofintraocular lens type (CAT or PHAKIC) and insertion position (anteriorchamber or posterior chamber). These data are automatically read fromthe patient's electronic record through the hospital LAN and displayedon the screen.

[0053] The data reading from the electronic medical record is made by ahospital network access program installed in the service utilizingterminal. An item with no data from the electronic medical record isdisplayed as blank, and the doctor inputs a numerical value from akeyboard of the service utilizing terminal in accordance with necessity.Further, if the doctor desires, a numerical value of the input item,read from the electronic medical record, can be rewritten with adifferent numerical value. An execution button of “search appropriatelens” is displayed in a lower part of the screen image, and if thisbutton is clicked by the mouse, the process moves to the next step 103.Further, for the user's customizing a parameter as lens selectioncriterion, a “customize parameter” button is displayed.

[0054] At step 103 (search for appropriate lens), the lens-selectionsupport service providing system 46 searches for an appropriateintraocular lens in accordance with the patient data received via theInternet and a predetermined selection criterion. The procedure of thelens search is as described bellow.

[0055] First, a lens power appropriate to the patient's eye iscalculated by utilizing a lens power formula for selecting a lens powerwhich is well known in the field of ophthalmology. SRK/T formula is oneof the lens power formulas. The details of the expression is describedin John A. Retzlaff, MD et al.: “LENS OMPLANT POWER CALCULATION (ThirdEdition), SLACK Incorporated. Further, other various lens power formulassuch as the Binkhorst formula, the Colenbrander-Hoffer formula and theRegression formula than the SRK/T formula may be used in place of theSRK/T calculation.

[0056] Parameters used in the SRK/T calculation include a parametercalled A constant specific to an intraocular lens type, and otherparameters such as anterior chamber depth. In some cases, theseparameters should be slightly varied in accordance with intraocular lensmaker. Generally, the lens supplier provides recommended parametervalues, however, in some cases, the numerical values are varied byrespective doctors' decision, which corresponds to so-called doctor'sknow-how.

[0057] In the present embodiment, when the user depresses the “customizeparameter” button, an input item for inputting a numerical value of theabove-described A constant, different from the maker's recommendedvalue, is displayed, and the user inputs a numerical value andcalculates a lens power. The value of the A constant used in the lensselection calculation is automatically recorded in the lens-selectionsupport service providing system 46 of the lens supplier. As describedlater, the recommended A constant value is obtained by averaging valuesfrom many users. Generally, this value is used in lens powercalculation.

[0058] The lens-selection support service providing system 46 obtainsthe lens power by the above formula, then searches the database with theobtained value as a search condition, and further with other patientdata such as the corneal diameter data and the pupil diameter data asother search conditions, for lenses satisfying all the searchconditions. That is, from the various types of intraocular lenses storedin the database, lenses satisfied “the lens type having the calculatedlens power (condition 1)” and “the lens appropriate to the patient'scorneal diameter data and pupil diameter data and the like (condition2)” are extracted. As a result of search, all the models of intraocularlenses having corresponding power and lens diameter specification areselected. In the present embodiment, as the database of thelens-selection support service providing system includes data on variousmodels of intraocular lenses by plural makers as well as data on 1 maker(the supplier itself), a search for an appropriate intraocular lens canbe made regardless of maker.

[0059] At step 104 (display search result), the result of the abovesearch is displayed in list form on the service utilizing terminal. FIG.6 is an example of the search result displayed on the display screen ofthe service utilizing terminal. In this example, lenses by differentmakers satisfying the search conditions are displayed in the list,however, it may be arranged such that only models of specific 1 maker(the supplier itself) are displayed. Further, stock statuses, i.e.,whether or not the selected intraocular lenses are in stock, aredisplayed. The stocks are checked by accessing the company stock controlsystem (44) from the service providing system (46) via the company LAN(40) (via the Internet in use of rental server). The doctor finallydetermines a lens based on the search result. Then the doctor opens thepatient's electronic medical record, and inputs the model, the power, apredicted refraction value after insertion, the features of the selectedlens and the like, into the electronic medical record.

[0060] Note that if the doctor cannot find an appropriate lens from thesearch result, as the process returns to the patient data input image inFIG. 5 by depression of “re-search” button in FIG. 6, the doctor canslightly vary the patient data values or selection parameters and makeanother search. Further, if the patient's eye is extraordinary and anyof standardized lenses cannot be used, an order can be placed for acustomized lens to be manufactured in a factory.

[0061] At step 105 (online ordering), an online service to receive anorder for an intraocular lens is provided. This service operates incooperation with the online ordering service system (45) of the lenssupplier on the initiative of the local server of the hospital. Theservice user is not conscious of the position of the server.

[0062] In a case where an online order is made immediately after thesearch by the lens-selection support service, the “online ordering”button is depressed in the screen image in FIG. 6 showing the searchresult. Then the screen changes to an online ordering image as shown inFIG. 7. In the screen image, 4 input items of maker, a model name, apower and the volume of on-order lens are displayed, and plural orders(order 1, order 2, order 3, . . . ) can be made. At normal times, theresults of search by the lens-selection support service is automaticallyinputted into the respective items and displayed. Then the user deletesunnecessary items leaving necessary ones, thereby designates on-orderlens(es). After the designation, when an “OK” button in a lower positionof the screen image is clicked, the screen changes to an order checkimage as shown in FIG. 8. Note that if the “online ordering” is selectedin the service selection at the initial step 101 (FIG. 4), the screendirectly changes to an ordering image in FIG. 7 for placement of neworder. In the case of new order, as input items are blank, desired nameand numerical values are inputted into one or plural fields of themaker, the model name, and the power, then a desired number is inputtedinto the item of volume of on-order lens (in use of pull-down menu forselection, the operability can be improved), and an “OK” button isdepressed. Then models corresponding to the conditions are displayed inlist as shown in FIG. 8.

[0063]FIG. 8 is an example of screen image to finally check an onlineorder displayed on the service utilizing terminal. The stock statuses ofthe respective intraocular lenses in the hospital, and stock statuses ofthe lenses in the maker are automatically checked and check results aredisplayed on the right side of the screen. It may be arranged such thatnumerical values indicating the number of stocked items instead of stockstatuses are displayed. The data on the stock in the hospital isprovided from the hospital stock control system (16, 26, 35), and thedata on the maker stocks is provided from the maker stock control server44. The service user checks the displayed contents and clicks “order”,and the order is completed. Upon completion of order, as the intraocularlens used in treatment of the patient's eye is determined, theinformation of the lens is inputted in the electronic medical record.Note that if “cancel” is clicked, the order is cancelled. Furthermore,it is also possible to order other medical instruments to secure thestock. Such an order does not synchronize with the medical record.

[0064] Regarding the intraocular lens on order by the online ordering,process differs in accordance with its stock status in the hospital. Ifthe lens is stocked in the hospital, the on-order lens, the orderer andthe orderer department and the like are recorded in the hospital stockcontrol system, and the stock control department of the hospitaldelivers the intraocular lens in accordance with the place and time ofthe surgery. If the lens is insufficient in stock, an order isautomatically placed with the online ordering system (45) of the lenssupplier via the Internet.

[0065] At step 106 (receive supplied lens), if the lens is stocked inthe hospital, the on-order lens is delivered to the doctor to performthe surgery from the stock control department of the hospitalimmediately or at necessary timing. Further, if an order has been placedwith the external supplier, the on-order lens is supplied from thebusiness department or distribution department of the lens supplier tothe stock control department of the hospital, then the serial number ofthe product is registered in the hospital stock control system, and thelens is delivered to the doctor at necessary timing.

[0066] At step 107 (treatment/surgery), the supplied intraocular lens isplaced in the patient's eye.

[0067] The doctor to perform the surgery or assistant finally checkswhether or not the intraocular lens is the lens selected for thepatient, on the spot, by using a foolproof system. The procedure of thefinal checking will be described. As shown in FIG. 10, a label on whicha product serial code (identification code of numerals or symbols)unique to each delivered product is printed as a bar code, is attachedto a product package in which the intraocular lens is encapsulated. Theproduct serial code includes three types of information, a codeidentifying a model name, a production number (serial number unique toeach of products of even the same model), and a lens power. On thelabel, the model name and the lens power are described in characters soas to be visually checked by the user.

[0068] When the package is opened, the doctor or assistant checks thedescription of the label by visual observation. At the same time, thedoctor or assistant reads the bar code on the package by a bar codereader of operation terminal at an operating room. The operationterminal displays the lens model name and the lens power included in thebar code. At the same time, the operation terminal refers to thepatient's electronic medical record via the hospital LAN to checkwhether or not the model and the lens power of the intraocular lenshaving the product serial code read by the bar code reader correspondwith the product information in the electronic record, i.e., the lensmodel and the lens power of the on-order intraocular lens selected bythe doctor. Then the operation terminal informs the doctor/assistant ofthe correspondence between the data, by a screen image on the display ora message from a speaker. The doctor checks the result of comparison bythe display or voice message and then starts the surgery.

[0069] By this pre-surgery foolproof system, the probability of humanmistake such as use of wrong intraocular lens can be prevented. As aparticular example of the operation terminal, a handy terminal with abuilt-in computer, connected to the hospital LAN with a radio networkinterface or the like can be used with excellent operability. Further, alaptop PC or desktop PC with a network interface may be employed.

[0070] At step 108 (update medical record/selection criterion), thepatient data on the electronic medical record is updated. The productserial code read by the bar code reader of the operation terminal uponsurgery is automatically recorded into the patient's electronic medicalrecord. At the same time, the product name, the date of use, and theresponsible doctor's name (user code) are also automatically recorded inthe electronic medical record. After the surgery, if the doctor inputscomment on a usage pattern of the intraocular lens (including qualityand claim information) from the above operation terminal or anotherterminal, the comments are also recorded into the electronic medicalrecord. Further, immediately after or after the surgery, the patient'seye is measured by the various measuring devices for observation ofpost-surgery status, and the measured data are also recorded in theelectronic medical record through the hospital LAN.

[0071] Further, a part of the information recorded in the electronicmedical record, i.e., a part of the measured data, and information onthe product serial code, the date of use, the place of use, the usagepattern and the like of the intraocular lens inserted in the patient'seye are provided to the lens supplier via the Internet. Further, theinformation on the stock from the hospital stock control system 16, 26and the company stock control system 35 are recorded in the database ofthe company stock control system of the lens supplier. Further, afterthe surgical implantation of the intraocular lens, a form called apatient card is handed to the patient from the hospital. The productserial number is printed on the patient card. If the patient writespersonal information, comments on use of the lens, opinions and the likein the patient card and sends it to the lens supplier, the supplierinputs the data from the card and records the data, in relation with theproduct serial number, into the above-described database.

[0072] Further, the lens-selection support service providing system 46on the lens supplier side re-calculates the A constant of theabove-described lens power formula (SRK/T formula) based on the receivedmeasured data, and automatically updates data in correspondence with thelens type. A particular method of updating is as follows.

[0073] Now, it is assumed that a patient is a n-th service user. Themeasured data of the patient (e.g., naked eye refraction=D0, correctedrefraction=D) is transmitted from the hospital. Assuming that themaker's recommended value, the initial A constant is A0, the value ofthe A constant obtained by using the above values D0 and D is A′, andthe lens power of the used intraocular lens is P, the A constant isupdated as follows. Note that the initial constant A0 is weighted for1000 patients, however, the value of the constant may be varied.

[0074] The n-th A value is updated by:

[0075] (1) If |P|≧10 holds,

[0076] |D-D0|≦2: A=A0×(1000+n−1)+A′/(1000+n)

[0077] |D-D0|≧2: no change

[0078] (2) If 10>|P|≧5 holds,

[0079] |D-D0|≦1: A=A0×(1000+n−1)+A′/(1000+n)

[0080] |D-D0|>1: no change

[0081] (3) If P<5 holds,

[0082] |D-D0|≦0.5: A=A0×(1000+n−1)+A′/(1000+n)

[0083] |D-D0|>0.5: no change

[0084] The updated A constant is a value which reflect the many past Aconstant values used by all the users of the present service regardingthe lens, i.e., the updated constant A means a comprehensive survey ofknow-how regarding selection of the lens. This A constant is used as themaker's recommended value for the next lens power calculation. That is,the present system is a know-how absorbing type learning system wherethe A constant optimum of each of various intraocular lenses i.e.selection criterion evolves to more reliable value as the number oftimes of use and the number of users increase. Further, the doctor cancheck whether or not his/her know-how is appropriate. This arrangementincreases the reliability of the lens selection, and contributes to thehomogeneity of selection by reducing variation in selection byrespective doctors.

[0085] The flow of the service viewed from the medical institution sideis as described above. FIG. 3 is a flowchart showing the procedure oflens supply service viewed from the lens supplier side.

[0086] At step 201 (provide lens selection online service), theabove-described online service is provided through the Internet to themedical institutions such as the hospital A (1), the hospital B (2) andthe medical laboratory (3). The lens-selection support service providingsystem (46) is placed on the server of the company LAN of the lenssupplier or the rental server (7). Access to the server via the Internetis permitted from the service utilizing terminal of the respectivemedical institutions, and the selection of intraocular lens used in therespective medical institutions is supported. Otherwise, as in the caseof the hospital B in FIG. 1, a program to provide the service or datamay be installed in a local service providing server of the hospitalLAN. In this case, the lens selection criterion parameter (A constant)is updated every time the electronic medical record is updated by thehospital after surgery, and the selection criterion becomes morereliable as the number of times of service use increases.

[0087] At step 202 (receive online order), an online order from themedical institution is received. The nucleus of the online orderingsystem to provide the service is constructed in the local serverscontrolled by the stock control departments of the respective hospitals,while the online ordering system (45) to handle orders from the stockcontrol departments is placed on the server of the company LAN of thelens supplier or the rental server. Further, the online ordering system(45) can access the company stock control system (44) to obtaininformation on the stock in the company.

[0088] The company stock control system (44) performs centralizedcontrol on the stocks of all the products handled by the lens supplier.The company stock control system (44) has a database holding variousinformation such as product serial codes (model names and productionnumbers), dates of production, places of stocks, dates of delivery,dates of use, places of use, usage patterns of all the productsmanufactured in the factory, and comments from the medical institutions.It can be checked, from the identification code of on-order product,whether or not the on-order product is in stock for delivery byaccessing the database. If it is determined that the product is instock, the online ordering system instructs a computer of the businessdepartment or the distribution department to deliver the on-orderproduct to the hospital (step 204). Under the instruction, the businessdepartment or the distribution department immediately delivers theon-order product to the hospital.

[0089] As the online ordering service is provided in conjunction withthe lens-selection support service, the medical institutions can placean order for a selected lens on the spot, thus accurate and quickordering is realized. Considering a case where a patient is to undertakeemergency surgery using an intraocular lens and the lens must besupplied as quick as possible, the level of urgency can be designatedupon ordering. In this case, as described below, if the lens isinsufficient in stock in the hospital and the maker, the stock of thelens in another medical institution is supplied.

[0090] At step 203 (check company stock), it is checked whether or notthe on-order intraocular lens is in stock in the company. If the lens isinsufficient in stock and the order is urgent, the online orderingsystem checks stocks outside the company. The system sequentiallyaccesses the stock control systems of medical institutions such ashospitals and laboratories around the orderer hospital, as well as thehospital stock control system of the orderer hospital, via the Internet,to examine whether or not the on-order product is stocked. For thispurpose, the lens supplier has previously-assigned limited access rightto at least search stock statuses of their products in the stock controlsystems 16, 26 of the respective medical institutions and the companystock control system 35.

[0091] The online ordering system sequentially searches plural positionsregarding which the system has access right. Then based on the searchresults, makes a list of medical institutions having an extra stock ofthe on-order product, in the order of distance and time, from theclosest institution. The system issues an instruction, with the listedresults, to the computer of the business department or the distributiondepartment to supply the product (step 204). Under the instruction, thebusiness department or the distribution department dispatches aresponsible person to a medical institution that can supply the productmost quickly, to deliver the necessary number of products from the extrastock to the orderer hospital. Thus, an order for lens used in anemergency medical treatment can be handled.

[0092] Note that at step 203, when the stock control server controlledby the medical institution is accessed from the lens supplier, stocks ofother types of intraocular lenses supplied by the supplier in the pastare examined. As a result, insufficient or out-of-stock product(s) canbe found. The online ordering system first checks the stock of theinsufficient product in the company stock control system, and if theproduct is in stock, instructs the computer of the business departmentor the distribution department to voluntarily supply the product to themedical institution in which the product is out of stock. If the productis not stocked in the company, the system instructs the factory tomanufacture the out-of-stock product (step 205). In this manner, thesystem is constructed to appropriately supply insufficient/out-of-stockproduct by utilizing the lens supplier's access partly permitted to thestock control servers of the medical institutions, thereby the medicalinstitutions can always obtain sufficient stocks.

[0093] At step 205 (instruct factory to manufacture lens), if the lensis out of stock or a small amount of stock in the supplier and theoutside the company, the system instructs a computer of the factory tomanufacture the intraocular lens. The factory manufacture the on-orderproduct quickly and ship the product so as to solve the shortage of thestock. Further, the system receives an online order for a customizedproduct for an extraordinary patient's eye in which no standardized lenscan be inserted, then the development department designs the customizedlens corresponding to the order, and the factory manufactures the lens.In this case, the Internet and the network of the company LAN areutilized and quick manufacturing and supply of the product can beperformed. As shown in FIG. 10, each of pre-shipment product packagescompleted in the factory has a bar code label displaying a uniqueproduct serial code. For control of shipped products by bar code, thecompany stock control system is accessed via the company LAN from thefactory computer, and records of new product serial codes are added tothe database.

[0094] As described above, a part of information recorded in theelectronic medical record in the hospital, e.g., a part of measureddata, and information on the product serial code, the date of use, theplace of use, the usage pattern and the like of the intraocular lensinserted into the patient's eye are provided via the Internet to thelens supplier. Further, the information on the stock status of theproduct is recorded in the database of the company stock control systemof the lens supplier. Further, the information from the patient card isalso recorded in the same database. That is, by introduction of thepresent system, the lens supplier can obtain information of shippedproducts from the medical institutions and perform follow-up control. Astime and place of use of each shipped product can be obtained incorrespondence with the product serial code, after-sales support foreach product can be easily made. Further, the usage pattern of theproduct, i.e., information on the quality and claim and the patient'scomments and opinions are useful information for improvement of theproduct. These information are stored in the database of the companystock control system, and accessible from the development department,the manufacturing department and the like via the company LAN. As theuseful information can be shared in the company, product development andimprovement can be quickly made. Further, the manufacturing technologycan be improved.

[0095] As described above, according to the present invention, theproblem of supply of medical instruments specific to the medical field,that demands cannot be predicted without difficulty and products must bequickly supplied, can be solved. That is, the medical institution cantimely receive a medical instrument, and the supplier of medicalinstrument can efficiently perform delivery and manufacturing control.That is, the introduction of the present invention brings profits to theboth medical institution and supplier, and greatly contributes to thedevelopment of medical industry.

[0096] Further, the present invention provides the selection supportservice for medical institutions to assist accurate selection of medicalinstrument regardless of experience or knowledge of the service user.

[0097] Further, the electronic medical recording system of the presentinvention can provide medical services covering details for respectivepatients by utilizing a communication network. Further, the presentinvention provides a foolproof system effective upon use of medicalinstrument to a patient and provides a terminal apparatus to realize thesystem.

[0098] Further, according to the present invention, the supplier ofmedical instrument can perform follow-up control on shipped products,thus attains timely development and improvement of products andafter-sales support.

[0099] As many apparently widely different embodiments of the presentinvention can be made without departing from the spirit and scopethereof, it is to be understood that the invention is not limited to thespecific embodiments thereof except as defined in the appended claims.

1-87. (Cancelled)
 88. An electronic medical recording system utilizing alocal area network in a medical institution, comprising: a server thathas a database for controlling individual medical record information ofrespective patients, accessible from said local area network; and aninput device that inputs information on a medical instrument used intreatment for a patient, wherein said information on said medicalinstrument inputted from said input device is recorded in said patient'selectronic medical record on said database.
 89. The system according toclaim 88, wherein input by said input device is performed upon treatmentfor said patient.
 90. The system according to claim 89, furthercomprising a safe system for final check before surgery based on saidinformation inputted from said input device.
 91. The system according toclaim 90, wherein said safe system accesses said patient's electronicmedical record by utilizing said local area network to check the recordagainst said information inputted from said input device.
 92. The systemaccording to claim 88, wherein said information on said medicalinstrument includes a product serial code of said medical instrument,and wherein said product serial code is attached as a bar code to saidmedical instrument, further wherein said input device includes a barcode reader that reads said bar code.
 93. The system according to claim88, wherein said input device includes a handy terminal, and whereininput is performed in a place where the treatment for said patient isperformed.
 94. (Currently Amended) The system according to claim 88,wherein said information on said medical instrument is transmitted tosad a supplier of said medical instrument via the Internet or a privatecommunication line from said local area network in said medicalinstitution.
 95. The system according to claim 88, wherein said medicalinstrument is an implanted tool placed in a patient's body.
 96. Thesystem according to claim 88, wherein said medical instrument is anintraocular lens, and wherein said information on said medicalinstrument is attached to a package of said intraocular lens. 97.(Currently Amended) A terminal apparatus used in a system utilizing alocal area network in a medical institution, which includes a serverthat has a database for controlling individual medical recordinformation of respective patients accessible from said local areanetwork, said terminal apparatus comprising: a bar code reader; adisplay; a computer that displays at least some of information on amedical instrument to be used on said display based on the result ofreading a bar code attached to said medical instrument by said bar codereader; and a transmitting unit which transmits at least some of saidinformation to said server via said local area network.
 98. Theapparatus according to claim 97, further comprising a network interfacefor connection with said local area network of said medical institution.99. The apparatus according to claim 97, wherein said terminal apparatusis a handy terminal.
 100. The apparatus according to claim 97, whereinsaid terminal apparatus is used in a safe system for checking whether ornot said medical instrument to be used is proper before surgery. 101.The apparatus according to claim 97, wherein said medical instrument isan implanted tool placed in a patient's body.
 102. The apparatusaccording to claim 97, wherein said medical instrument is an intraocularlens, and wherein said information on said medical instrument isattached to a package of said intraocular lens.
 103. The apparatusaccording to claim 102, wherein a bar code is presented on said medicalinstrument, and said bar code includes a product serial code of saidmedical instrument, and wherein said product serial code includes one ormore of information from a model, a product serial number, and a lenspower of said intraocular lens.
 104. A medical safe system utilized in amedical institution, comprising: an input device that inputs informationon a medical instrument used in treatment for a patient upon thetreatment; and a computer that checks said information on said medicalinstrument inputted from said input device against said patient'selectronic medical record on an electronic medical recording system ofsaid medical institution.
 105. The system according to claim 104,wherein said medical instrument is an implanted tool placed in apatient's body.
 106. The system according to claim 104, wherein saidmedical instrument is an intraocular lens, and wherein said informationon said medical instrument is attached to a package of said intraocularlens.
 107. The system according to claim 106, wherein said informationon said medical instrument includes a product serial code of saidmedical instrument, and wherein said product serial code is attached asa bar code to said medical instrument, further wherein said input deviceincludes a bar code reader that reads said bar code.
 108. The systemaccording to claim 104, wherein said input device includes a handyterminal, and wherein input is performed in a place where the treatmentfor said patient is performed.
 109. The system according to claim 104,wherein said information on said medical instrument is transmitted to asupplier of said medical instrument via the Internet or a privatecommunication line from sad a local area network in said medicalinstitution.